A 78-year-old white male was brought to your clinic by his daughter for increasing confusion. At your clinic, the patient is not oriented to place or situation but does not voice any complaints.

A 78-year-old white male was brought to your clinic by his daughter for increasing confusion. At your clinic, the patient is not oriented to place or situation but does not voice any complaints. These symptoms have increased over the past couple of days.
Allergies
NKDA
Past Medical History
HTN
CHF
DM – Type II
Peripheral neuropathy
Social History
no EtOH, no tobacco, widowed
Medications
Furosemide 40 mg daily
Potassium chloride 8 mEq daily
Aspirin 81 mg daily
Lisinopril 10 mg daily
Glyburide 5 mg two times daily
Amitriptyline 25 mg two times daily for neuropathy (started 4 years ago; no previous problems; no other medications have been as effective for his neuropathic pain)
Diphenhydramine 50 mg at bedtime prn for insomnia. This medication was started one week ago. The patient’s daughter believes he has been taking this consistently at night.
Vital signs and physical examination:
T 98.3 BP 114/78 P 76 RR 16 HT 5’10” WT 155lb
HEENT
PERRLA, EOMI
Neck
no lymphadenopathy, supple; no carotid bruits
Chest
CTA
CV
RRR, no murmurs
Abd
Normal BS, soft, nontender
Ext
no CCE
Neuro
A&0 X 2, CN II-XII grossly intact
Labs:
Sodium 135
Potassium 4.3
Chloride 101
CO2 24
BUN 15
Creatinine 1.1
Glucose 120
WBC 7.0, H/H 14.1/42, platelets 230
UA clear, sp gr 1.015, pH 6.5, prot -, glu -, ket -, (-) nitrite, (-) leukocyte esterase
As the primary care provider, how would yo manage the patient?
Complete one prescription for one of this patient’s medications.

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